Effectiveness of nonpharmacological stuttering interventions on communication and psychosocial functioning in adults: A systematic review and meta-analysis of randomized controlled trials

J Evid Based Med. 2021 Feb;14(1):17-26. doi: 10.1111/jebm.12408. Epub 2020 Nov 26.


Objective: To conduct a systematic review and meta-analysis of the research evidence examining the effectiveness of nonpharmacological stuttering therapy on communication and psychosocial functioning for adults who stutter.

Methods: A systematic search of nine electronic databases for studies published from database inception to December 2018 was completed to identify randomized controlled trials of interventions for adults with developmental stuttering. Two reviewers independently screened articles and assessed methodological quality using the Cochrane risk-of-bias tool. Treatment outcomes were classified using the International Classification of Functioning, Disability and Health (ICF) framework.

Results: The search yielded nine randomized controlled trials, comprising 276 participants, using a diverse range of interventions which were classified into four categories: speech restructuring interventions; speech restructuring plus psychological interventions; interventions with stimulating techniques and interventions targeting anxiety. Meta-analysis showed that interventions did not demonstrate a significant pooled difference when compared to comparison groups in improving speech fluency (standardized mean difference [SMD] = -0.35, 95% confidence interval [CI] -1.14 to 0.45, I2 = 81%, P = .39), overall experience of stuttering (mean difference [MD] = -0.10, 95% CI -0.36 to 0.15, I2 = 0%, P = .43) and quality of life (SMD = -0.32, 95% CI -0.83 to 0.19, I2 = 0%, P = .21).

Conclusions: This article identified a diverse range of treatments and outcome measures for adults who stutter, with meta-analysis highlighting no significant pooled difference between intervention and comparator groups in improving communication and psychosocial functioning.

Keywords: adults; meta-analysis; stuttering treatment; systematic review.

Publication types

  • Meta-Analysis
  • Systematic Review

MeSH terms

  • Adult
  • Communication
  • Humans
  • Psychosocial Functioning
  • Quality of Life
  • Randomized Controlled Trials as Topic
  • Stuttering* / therapy